Moldflow Simulation and Characterization of Pure Copper Fabricated via Metal Injection Molding.

Metal injection molding (MIM) is a representative near-net-shape manufacturing process that fabricates advanced geometrical components for automobile and device industries. As the mechanical performance of an MIM product is affected by green-part characteristics, this work investigated the green part of pure copper processed with MIM using the injection temperature of ~180 °C and injection pressure of ~5 MPa. A computational analysis based on the Moldflow program was proposed to simulate the effectivity of the process by evaluating the confidence of fill, quality prediction, and pressure drop of three distinctive regions in the green part. The results showed that the ring and edge regions of the green parts showed localized behavior, which was related to processing parameters including the position of the gate. A microstructural observation using scanning electron microscopy and a 3D X-ray revealed that both the surface and body matrix consisted of pores with some agglomeration of micro-pores on the edges and ring part, while any critical defects, such as a crack, were not found. A microhardness analysis showed that the three regions exhibited a reasonable uniformity with a slight difference in one specific part mainly due to the localized pore agglomeration. The simulation results showed a good agreement with the microstructures and microhardness data. Thus, the present results are useful for providing guidelines for the sound condition of MIM-treated pure copper with a complex shape.

Magnetically Driven Powerless Lighting Device with Kirigami Structured Magneto-Mechanoluminescence Composite.

The energy crisis and global shift toward sustainability drive the need for sustainable technologies that utilize often-wasted forms of energy. A multipurpose lighting device with a simplistic design that does not need electricity sources or conversions can be one such futuristic device. This study investigates the novel concept of a powerless lighting device driven by stray magnetic fields induced by power infrastructure for obstruction warning light systems. The device consists of mechanoluminescence (ML) composites of a Kirigami-shaped polydimethylsiloxane (PDMS) elastomer, ZnS:Cu particles, and a magneto-mechano-vibration (MMV) cantilever beam. Finite element analysis and luminescence characterization of the Kirigami structured ML composites are discussed, including the stress-strain distribution map and comparisons between different Kirigami structures based on stretchability and ML characteristic trade-offs. By coupling a Kirigami-structured ML material and an MMV cantilever structure, a device that can generate visible light as luminescence from a magnetic field can be created. Significant factors that contribute to luminescence generation and intensity are identified and optimized. Furthermore, the feasibility of the device is demonstrated by placing it in a practical environment. This further proves the functionality of the device in harvesting weak magnetic fields into luminescence or light, without complicated electrical energy conversion steps.

Simulation-Based Cybersecurity Testing and Evaluation Method for Connected Car V2X Application Using Virtual Machine.

In a connected car, the vehicle's internal network is connected to the outside through communication technology. However, this can cause new security vulnerabilities. In particular, V2X communication, to provide the safety of connected cars, can directly threaten the lives of passengers if a security attack occurs. For V2X communication security, standards such as IEEE 1609.2 define the technical functions that digital signature and encryption to provide security of V2X messages. However, it is difficult to verify the security technology by applying it to the environment with real roads because it can be made up of other safety accidents. In addition, vehicle simulation R&D is steadily being carried out, but there is no simulation that evaluates security for the V2X application level. Therefore, in this paper, a virtual machine was used to implement a V2X communication simulation environment that satisfies the requirements for the security evaluation of connected cars. Then, we proposed scenarios for cybersecurity testing and evaluation, implemented and verified through CANoe Option.Car2X. Through this, it is possible to perform sufficient preliminary verification to minimize the variables before verifying security technology in a real road environment.

Ultrasonic fatigue analysis of 3D-printed carbon fiber reinforced plastic.

The development of 3D printing technologies using composite materials has revolutionized additive manufacturing. Using these technologies, various products can be fabricated with strengths beyond the limits of the strength of the polymer used. However, although parts manufactured using carbon fiber reinforced plastic (CFRP) 3D printing have excellent characteristics, research on their durability is lacking, making their application difficult in the real industry. In this study, an ultrasonic fatigue test was conducted on a CFRP material manufactured by 3D printing to evaluate fatigue performance. Because of the characteristics of CFRP, the strength varies depending on the orientation angle of the carbon fiber, and the durability also varies. Therefore, an experiment on three types of specimens mixed in the bi-direction and uni-direction of 0° and 90° was conducted. For the ultrasonic fatigue test, a specimen design with a special shape is required according to the resonance frequency and dynamic modulus of the material. To this end, a specimen was designed based on measurements of the physical properties of the material according to the angle of the fiber, which were verified by Finite element method (FEM) modal analysis, and the fatigue life was estimated through an actual experiment. The fatigue failure life was simulated by FEM fatigue analysis considering the measured fatigue test results and the derived anisotropic properties simultaneously. Additionally, based on the advantages of CFRP 3D printing, which adjusts the fiber pattern, we fabricated a specimen with a concentric pattern to derive the fatigue life and calculate the actual life improvement. Based on the results of this study, the specific rigidity of the CFRP parts can be optimized by adjusting the fiber pattern. Additionally, the results of this study can aid in the analysis of the fatigue characteristics of 3D-printed CFRP materials.

Multi-target cell therapy using a magnetoelectric microscale biorobot for targeted delivery and selective differentiation of SH-SY5Y cells via magnetically driven cell stamping.

Cell therapy refers to a treatment that involves the delivery of cells or cellular material by means of injection, grafting, or implantation in order to replace damaged tissue and restore its function, or to aid the body in fighting disease. However, limitations include poor targeting delivery and low therapeutic efficacy due to low cell survival. Hence, novel approaches are required to increase cell delivery efficiency and enhance therapeutic efficacy via selective cell differentiation at target areas. Here, we present a stamping magnetoelectric microscale biorobot (SMMB) consisting of neuron-like cell spheroids loaded with magnetoelectric nanoparticles. The SMMB enables not only effective targeted delivery of cells to multiple target areas (via minimally invasive stamping employing magnetic actuation) but also facilitates selective neuronal differentiation via magnetoelectric (ME) stimulation. This ensures rapid colonization and enhances efficacy. SMMBs were fabricated using SH-SY5Y cells. Magnetoelectric nanoparticles for ME stimulation responded to an alternating magnetic field that ensured targeted cell differentiation. Multi-target cell therapy facilitated the targeted delivery and selective differentiation of SH-SY5Y cells to multiple regions using a single SMMB with rotating and alternating magnetic fields for delivery and ME stimulation. This promising tool may overcome the limitations of existing cell therapy for neurodegenerative diseases.

The influence of core service quality associated with Korean women's volleyball on national image and consumption engagement of Korean products: Perspective of Korean Wave in Thailand.

Building on the stimulus-organism-response (SOR) framework, we proposed and tested a hypothesized model examining the effect of core service quality on national image and related behavioral intentions (i.e., intention to visit Korea and intention to purchase Korean products). Using 286 samples collected from Nakhon Ratchasima, Thailand, during the Korea-Thai Super Match, we conducted confirmatory factor analysis (CFA) and structural equation modeling (SEM) to examine the measurement model and the hypotheses, respectively. The results revealed that player attractiveness and emotional experience positively affected national image and behavioral intentions (i.e., intention to visit Korea and purchase Korean products). The findings stress that foreign spectators' attitudes toward Korean women's volleyball could translate into consumption behaviors (i.e., visits and Korean products) through the national image.

Moderating Effect of the Power-Distance Belief on the Relationship between Employees' Service Failures and Customers' Behavioral Outcomes in the Sport Service Industry.

This study was designed to examine the moderating effects of the power-distance belief (PDB) on the relationship between employees' service failures and customers' transactional and non-transactional outcomes in a fitness center context. To test the relationships among these variables, we employed two pretests and a main experiment. In Pretest 1, a critical incident technique (CIT) was used to identify the employees' service failure situations in fitness centers. Then, in Pretest 2, we developed two written scenarios that described employees' service failures according to low and high severity and confirmed the differences between these two scenarios with a manipulation check. In the main experiment, we employed scenarios to examine the relationships among service failures' severity, PDB, and customers' non-transactional and transactional outcomes. We used Hayes' PROCESS macro to test the PDB's single moderating effect on the relationship between the service failures' severity and the customers' responses. According to the results, the moderating effect on the relationship between the service failures' severity and fitness center customers' non-transactional and transactional behaviors was confirmed. We extended the understanding of fitness center customers' reactions, depending upon individual PDB to service failures, by comparing low- and high-service failure situations. Our findings also suggest that segmenting fitness center customers may help managers recognize that their customers' varying responses depend on PDB.

Atelocollagen Enhances the Healing of Rotator Cuff Tendon in Rabbit Model.

BACKGROUND: Failure of rotator cuff healing is a common complication despite the rapid development of surgical repair techniques for the torn rotator cuff. PURPOSE: To verify the effect of atelocollagen on tendon-to-bone healing in the rabbit supraspinatus tendon compared with conventional cuff repair. STUDY DESIGN: Controlled laboratory study. METHODS: A tear of the supraspinatus tendon was created and repaired in 46 New Zealand White rabbits. They were then randomly allocated into 2 groups (23 rabbits per group; 15 for histological and 8 for biomechanical test). In the experimental group, patch-type atelocollagen was implanted between bone and tendon during repair; in the control group, the torn tendon was repaired without atelocollagen. Each opposite shoulder served as a sham (tendon was exposed only). Histological evaluation was performed at 4, 8, and 12 weeks. Biomechanical tensile strength was tested 12 weeks after surgery. RESULTS: Histological evaluation scores of the experimental group (4.0 ± 1.0) were significantly superior to those of the control group (7.7 ± 2.7) at 12 weeks ( P = .005). The load to failure was significantly higher in the experimental group (51.4 ± 3.9 N) than in the control group (36.4 ± 5.9 N) ( P = .001). CONCLUSION: Histological and biomechanical studies demonstrated better results in the experimental group using atelocollagen in a rabbit model of the supraspinatus tendon tear. CLINICAL RELEVANCE: Atelocollagen patch could be used in the cuff repair site to enhance healing.

In vivo analysis of acromioclavicular joint motion after hook plate fixation using three-dimensional computed tomography.

BACKGROUND: The clavicle hook plate can be used to treat acromioclavicular and coracoclavicular ligament injury or distal clavicular fracture with comminution. However, the hook plate can induce subacromial impingement, resulting in discomfort from the hardware. METHODS: Our inclusion criteria were (1) men and women aged older than 20 years and (2) the presence of comminuted distal clavicular fractures (Neer type IIB) fixed with a hook plate (Synthes, Oberdorf, Switzerland). Three-dimensional computed tomography was obtained before removal of the hook plate. Seven patients were enrolled prospectively. The mean age was 42 years (range, 24-60 years). Zero degree images and abduction images were obtained. The sagittal cut surface was obtained 5 mm medial from the distal clavicle. The equator of the cut surface of the clavicle was compared with the full abduction model to analyze rotation. The center of the cut surface of the clavicle was compared with the full abduction model to analyze translation. RESULTS: The average difference in rotation of the distal clavicle between both shoulders was 16° (range, 3°-22°; P = .001). The mean difference in anterior translation of the distal clavicle was 2.2 mm (range, -0.7 to 5.6 mm; P = .030). CONCLUSION: Hook plate fixation at the acromioclavicular joint causes decreased internal rotation and increased anterior translation of the distal clavicle with respect to the medial acromion, indicating that the scapula relative to the thorax has decreased posterior tilting and increased external rotation in shoulders fixed using a hook plate.

Repair of a radial tear in the posterior horn of the lateral meniscus.

BACKGROUND: There have been no studies evaluating the clinical results after repair of a radial tear in the posterior horn of the lateral meniscus (PHLM) using the FasT-Fix system. This study was undertaken to evaluate the clinical outcomes after repair of a radial tear in the PHLM using the FasT-Fix system in conjunction with anterior cruciate ligament (ACL) reconstruction. METHODS: Between September 2008 and August 2011, 15 radial tears in the PHLM identified during 132 consecutive ACL reconstructions were repaired using the FasT-Fix meniscal repair system. We classified the radial tears into three types according to the tear patterns: simple radial tear, complex radial tear, and radial tear involving the popliteal hiatus. Postoperative evaluation was performed using the Lysholm knee score and Tegner activity level. Second-look arthroscopy was performed in all cases. RESULTS: The mean follow-up period was 24 months. None of the patients had a history of recurrent effusion, joint line tenderness or a positive McMurray test. The meniscal repair was considered to have a 100% clinical success rate. At the final follow-up, the Lysholm knee score and Tegner activity level were significantly improved compared to the preoperative values. On the second-look arthroscopy, repair of radial tears in the PHLM in conjunction with ACL reconstruction using the FasT-Fix device resulted in complete or partial healing in 86.6% of cases. CONCLUSION: Clinical results after meniscal repair of a radial tear in the PHLM by using the FasT-Fix system were satisfactory. LEVEL OF EVIDENCE: Case series, Level IV.

The diagnostic role of diffusion tensor imaging in multifocal inflammatory leukoencephalopathy.

Multifocal inflammatory leukoencephalopathy (MIL) is a rare syndrome that can occur in patients with colon cancer after chemotherapy with 5-fluorouracil (5-FU) and levamisole. Histologic diagnosis by brain biopsy is most effective, but there can be high surgical risks and technical limitations. Therefore, we introduce a noninvasive diagnostic technique using diffusion tensor imaging (DTI) for patients suspected to have MIL. A 45-year-old woman had been treated for 12 weeks with levamisole and 5-FU for adenocarcinoma of the cecum, when she complained of ataxia, diplopia and left ptosis. Brain MRI showed a nodular enhancing lesion in the left midbrain, using gadolinium enhanced T1-weighted imaging, and scattered multiple white matter lesions throughout the cerebral hemisphere. Instead of a brain biopsy, DTI was performed that revealed reduced fractional anisotropy (FA) and increased radial diffusivity (RD) in the left midbrain lesion compared with the right midbrain denoting demyelination. Levamisole and 5-FU were discontinued, and she received intravenously 1 g of methylprednisolone daily for 5 d. After five weeks, follow-up DTI showed an increased FA and decreased RD, signifying the reversibility. DTI therefore may provide valuable information on diagnosing MIL and assessing the treatment response.

Sesamoidectomy and volar plate repair using suture anchor for hyperextension injury of the metacarpophalangeal joint of the thumb.

A retrospective study for the combination of suture anchor and selective sesamoidectomy for treating volar instability of the metacarpophalangeal joint (MCPJ) of the thumb. Eleven patients with hyperextension of the MCPJ of the thumb underwent volar plate repair using a volar or voloradial approach. All the patients were reviewed radiologically and clinically using both objective and subjective criteria. The patients presented with sesamoid fractures (n = 2), sesamoid subluxation (n = 1), isolated volar plate laxity (n = 4), isolated sesamoid fracture (n = 4), and metacarpal condyle fracture (n = 2). The inner intersesamoid distance was 4.6 mm and the outer intersesamoid distance was 14.2 mm. The Disabilities of the Arm Shoulder and Hand and Michigan Hand Outcomes Questionnaire scores showed improvement. Volar plate repair using a suture anchor and selective sesamoidectomy is effective with regard to pain relief and stabilisation of volar instability of the thumb.

Subluxation of the extensor carpi ulnaris tendon associated with the extensor digitorum tendon subluxation of the long finger.

A twenty-year-old male visited our clinic with wrist and long finger metacarpophalangeal (MP) joint pain. Dynamic ultrasonography revealed sagittal band (SB) ulnar subluxation and extensor carpi ulnaris (ECU) volar subluxation. Magnetic resonance imaging showed longitudinal splitting and dislocation of the volar half slip of the ECU tendon. The redundant radial SB was augmented and ECU sheath was advanced to the periosteum using suture anchors. He was able to perform his previous activities at the last follow-up. We encountered a case of "simulateous" ECU dislocation with extensor tendon subluxation of the long finger at the MP joint. Therefore, we report this case with a review of the relevant literature.

Early clinical results of reverse total shoulder arthroplasty in the Korean population.

BACKGROUND: We evaluated the short-term clinical outcomes and compared the component's sizes of reverse total shoulder arthroplasty (RTSA) in Korean Population. MATERIALS AND METHODS: We performed an RTSA on 42 patients between December 2007 to February 2010. The mean age at surgery was 72.5 ± 5.6 (10 men, 32 women) and average follow-up period was 24 months. Twenty-two cuff tears arthropathy, 15 irreparable massive rotator cuff tears with pseudoparalysis, 5 proximal humeral fractures, and 2 infection cases were included. We evaluated clinical outcomes and also the intra- and postoperative complications to determine if any of the complications were unique to the use of a RTSA in a Korean population. In the anatomic study, 92 uninjured shoulders of 92 patients were used for measuring the inferior glenoid size, and we compared the component's sizes of RTSA with those of the normal population. RESULTS: The ASES (American Shoulder and Elbow), UCLA, and KS (Knee Society) scores significantly improved from preoperative 35 (0-63), 12 (5-27), and 39 (3-81) to postoperative 68 (37-95), 24 (16-35), and 68 (34-88), respectively (P < .05). Postoperative complications were seen in 20% and scapular notching 35%. Three patients required further surgery for shoulder dislocation, periprosthetic fracture, and stem loosening. In the anatomic study, mean radius of the inferior glenoid was 17.1 ± 2.1 mm in male and 15.4 ± 1.6 mm in female. CONCLUSION: The short-term clinical results of an RTSA in Korean population are excellent despite high complication rate. However, the size of the glenoid is sometimes smaller than the baseplate (29 mm diameter) in female patients. More adequate size of the glenoid component should be considered.

Distal radioulnar joint volar instability after ligament reconstruction failure treated with sigmoid notch osteotomy.

Because osseous abnormalities result in distal radioulnar joint instability, a sigmoid notch osteotomy is used to restore stability. This article describes a case of distal radioulnar joint volar instability treated with sigmoid notch osteotomy of the volar rim.A 22-year-old man presented with a 9-month history of right wrist pain with volar instability after a fall, which was treated conservatively. He reported a history of remote trauma when he was 7 years old but had been asymptomatic since then. Four months later, he underwent anatomical distal radioulnar joint ligament reconstruction at another hospital after a diagnosis of distal radioulnar joint instability, but the instability had persisted.Computed tomography revealed dynamic volar subluxation of the ulnar head with hypoplasia and a flattened volar lip of the sigmoid notch. Therefore, a sigmoid notch osteotomy of the volar rim was performed. Postoperatively, an above-elbow cast was applied with forearm pronation for 6 weeks. Six months later, the patient had regained 60° of supination and 70° of pronation. He reported minor pain and no instability. Computed tomography scan at 6 months postoperatively revealed union of the osteotomy site and confirmed the maintenance of reduction. The patient returned to work.

Symptomatic residual instability with grade II acromioclavicular injury.

PURPOSE: Our objective was to evaluate the effectiveness of arthroscopic distal clavicle resection in cases presenting with pain and subtle instability after neglected grade II acromioclavicular (AC) joint dislocation. METHODS: From February 1998 to May 2006, 17 patients with symptomatic AC instability following chronic grade II AC joint injury were studied. Sixteen patients were male and one female, with a mean age of 48 years. An all-arthroscopic procedure comprising disk removal and distal clavicle resection was performed in all cases. All patients were reviewed clinically, preoperatively and at final follow-up (mean 38 months) using the pain score on a visual analog scale and the Constant score. Strength was measured using an Isobex digital strength analyzer. Patient's personal satisfaction after the procedure was documented as excellent, good or poor. Postoperative AC joint radiographs were routinely obtained in all patients to measure the amount of clavicle resection. RESULTS: Two patients underwent additional reconstructive surgery for disabling pain and dysfunction even after the arthroscopic resection procedure. The remaining 15 patients were analyzed. The pain scores improved significantly (p = 0.03). The mean pain score was 5.8 (range 5-9) before treatment and 1.6 (range 0-3) at follow-up. The Constant scores had improved significantly at the final follow-up (p = 0.001). The median Constant score increased from 46 (range 36-69) preoperatively to 71 (range 48-84) postoperatively. Strength had improved at the last follow-up. Eleven patients were satisfied and six were not satisfied with this procedure at the final follow-up. CONCLUSIONS: Arthroscopic distal clavicle resection statistically improved the pain score, Constant score and strength for grade II AC injury with subtle distal clavicle instability. However, six patients (33.5 %) were not satisfied subjectively. This procedure seemed to be a reasonable initial treatment option with lower morbidity.

Psychiatric symptoms and quality of life in patients with drug-refractory epilepsy receiving adjunctive levetiracetam therapy.

BACKGROUND AND PURPOSE: Levetiracetam (LEV) is a new antiepileptic drug that has been found to be effective as an adjunctive therapy for uncontrolled partial seizures. However, the results of several studies suggested that LEV has negative psychotropic effects, including irritability, aggressiveness, suicidality, and mood disorders. We investigated the impact of adjunctive LEV on psychiatric symptoms and quality of life (QOL) in patients with drug-refractory epilepsy (DRE) and determined the risk factors provoking psychiatric adverse events. METHODS: A 24-week, prospective, open-label study was conducted. At enrollment, we interviewed patients and reviewed their medical charts to collect demographic and clinical information. They were asked to complete self-report health questionnaires designed to measure various psychiatric symptoms and QOL at enrollment and 24 weeks later. RESULTS: Seventy-one patients were included in the study, 12 patients (16.9%) of whom discontinued LEV therapy due to serious adverse events including suicidality. The risk factor for premature withdrawal was a previous history of psychiatric diseases (odds ratio 4.59; 95% confidence interval, 1.22-17.32). LEV intake resulted in significant improvements in Beck Anxiety Inventory score (p<0.01) and some domains of the Symptom Checklist-90-Revised, such as somatization (p<0.05), obsessive-compulsiveness (p<0.05), depression (p<0.05), and anxiety (p<0.05). These improvements were not related to the occurrence of seizure freedom. The Quality of Life in Epilepsy Inventory-31 overall score and subscale scores, such as seizure worry (p<0.01), overall QOL (p<0.05), emotional well-being (p<0.05), energy-fatigue (p<0.05), and social function (p<0.05), also improved. CONCLUSIONS: Adjunctive LEV in patients with DRE is likely to improve psychiatric symptoms and QOL. Clinicians should be well aware of the psychiatric histories of patients to prevent them from developing serious adverse events related to LEV.

Differential effects of seizure control and affective symptoms on quality of life in people with epilepsy.

OBJECTIVE: The purpose of the study was to delineate how affective symptoms (AS) influence quality of life (QOL) for individuals with drug-refractory epilepsy (DRE) and those with well-controlled epilepsy (WCE) independently. METHODS: All subjects participating in the study were asked to complete reliable and validated self-report health questionnaires, including AS, measured with the Korean versions of the Beck Depression Inventory, Beck Anxiety Inventory, and Quality of Life in Epilepsy Inventory-31 (QOLIE-31). We examined predictors of QOLIE-31 scores among the various demographic and clinical factors. We compared the effects of AS on QOL between patients with DRE and those with WCE and investigated the differential effects of seizure control and AS on QOL. RESULTS: Two hundred forty-nine patients with DRE or WCE were included in the study. The strongest predictor of QOL was AS, followed by seizure control and MRI abnormality. Affective symptoms had almost two times the effect of seizure control and six times the effect of MRI abnormality. Poorest QOL was noted in patients with DRE with AS, followed by those with WCE with AS, DRE without AS, and WCE without AS. CONCLUSION: The major determinant of QOL in patients with epilepsy is AS rather than DRE or WCE status.

Predictors of suicidal ideation in people with epilepsy living in Korea.

BACKGROUND AND PURPOSE: The risk of suicide or suicide attempts is reported higher in people with epilepsy (PWE) than in the general population. Although epileptic, psychiatric, and psychosocial factors are known risk factors for suicide or suicide attempt, no studies have evaluated the predictors of the severity of suicidal ideation-which is a warning sign for suicide attempts-in PWE. Therefore, we measured the severity of suicidal ideation and its risk factors. METHODS: Consecutive PWE who were medicated with antiepileptic drugs (AEDs) and attended epilepsy clinic were included in the study. The subjects completed self-reported questionnaires, which included the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Checklist-90-Revised (SCL-90-R), and Scale for Suicide Ideation-Beck (SSI-Beck). We compared the patients' demographic and clinical variables, and BDI, BAI, and SCL-90-R scores with their SSI-Beck score, and used our findings to determine the predictors for suicidal ideation. RESULTS: In total, 257 PWE were enrolled in the study. SSI-Beck scores correlated strongly with several seizure-related variables, duration of education, IQ, BDI and BAI scores, and nine domains of the SCL-90-R questionnaire. However, the strongest predictor for suicidal ideation was BDI score (beta=0.41, p<0.001), followed by several SCL-90-R domains, such as obsessive-compulsive (beta=-0.39, p<0.001), depression (beta=0.38, p<0.001), hostility (beta=0.22, p=0.002), paranoid ideation (beta=0.17, p=0.01), and IQ (beta=-0.10, p=0.017). These variables explained 59% of the variance in the SSI-Beck score. The seizure-related variables that influenced the BDI score were seizure frequency, duration of education, MRI abnormality, and number of AEDs. However, these variables explained only 18% of the variance in the BDI score. CONCLUSIONS: Major risk factors for suicidal ideation in PWE were depressive and psychiatric symptoms rather than seizure-related variables. Therefore, clinicians should focus on screening for depression and other psychiatric problems and treat them appropriately in order to reduce suicidal behavior in PWE. Since seizure-related variables also exhibited a minor role in determining depressive symptoms, stronger seizure-related risk factors for depression should be sought, such as seizure severity or psychosocial factors, to minimize suicidal behavior.